Gluteal Region Flashcards
What is the gluteal region?
An anatomical area located posteriorly to the pelvic girdle, at the proximal end of the femur
What do the muscles in the gluteal region do?
Move the lower limb at the hip joint
How can the muscles of the gluteal region be divided?
Superficial abductors and extenders
Deep lateral rotators
What are the superficial abductors and extenders?
A group of large muscles that abduct and extend the femur
What muscles are considered superficial abductors and extenders?
Gluteus maximus
Gluteus medius
Gluteus minimis
Tensor fascia lata
What are the deep lateral rotators?
A group of smaller muscles that mainly act to laterally rotate the femur
What muscles are considered to be the deep lateral rotators?
Quadratus femoris Piriformis Gemellus superior Gemellus inferior Obturator internus
What do the superficial gluteal muscles act to do?
Mainly to abduct and extend the lower limb at the hip joint
What is the largest of the gluteal muscles?
Gluteus maximus
What does the gluteus maximus produce?
The shape of the buttocks
What is the proximal attachment of the gluteus maximus?
Ilium posterior to the posterior gluteal line
Dorsal surface of the sacrum coccyx
Sacrotuberuous ligament
What is the distal attachment of the gluteus maximus?
Most fibres end in the iliotibial tract, which inserts into the lateral condyle of the tibia
Some fibres insert on the gluteal tuberosity
What is the innervation of the gluteus maximus?
Inferior gluteal nerve (L5, S1, S2)
What is the arterial supply of the gluteus maximus?
Superior gluteal artery
Inferior gluteal artery
What is the main action of the gluteus maximus?
Extends the thigh, especially from flexed position, and assists in its lateral rotation
Steadies the thigh and assists in rising from the sitting position
What shape is the gluteus medius?
Fan shaped
Where does the gluteus medius lie?
Between the gluteus maximus and the minimus
What is the proximal attachment of the gluteus medius?
External surface of ilium between anterior and posterior gluteal lines
What is the distal attachment of the gluteus medius?
Lateral surface of greater trochanter of the femur
What is the innervation of the gluteus medius?
Superior gluteal nerve (L5, S1)
What is the arterial supply of the gluteus medius?
Superior gluteal artery
What assists the gluteus medius in its action?
The gluteus minimus and tensor fasciae latae
Where does the gluteus minimus lie?
Deep to the other superficial gluteal muscles
What is the proximal attachment of the gluteus minimus?
External surface of the ilium between the anterior and inferior gluteal lines
What is the distal attachment of the gluteus minimus?
The anterior surface of the greater trochanter of femur
What is the innervation of the gluteus minimus?
Superior gluteal nerve (L5, S1)
What is the arterial supply of the gluteus minimus?
The superior gluteal artery
Where does the tensor fasciae latae lie?
Towards the anterior edge of the iliac crest
What does the tensor fasciae latae function to do?
Tighten the fascia lata
What is the proximal attachment of the tensor fasciae latae?
Anterior superior iliac spine
Anterior part of the iliac crest
What is the distal attachment of the tensor fasciae latae?
Iliotibial tract, which attaches to the lateral condyle of the tibia
What is the innervation of the tensor fasciae latae?
Superior gluteal nerve (L5, S1)
What is the arterial supply of the tensor fasciae latae?
Superior gluteal artery
What is the main action of the gluteus medius, minimus, and tensor fasciae latae?
Abduct and medially rotate the thigh
Keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase
Where do the gluteus medius and gluteus minimus have an important role?
In stabilising the pelvis during locomotion
What innervates the gluteus medius and minimus?
The superior gluteal nerve
When happens in the standing position when the conterolateral leg is raised?
The gluteus minimus and medius contract, preventing the pelvis from dropping to that side
What happens if the superior gluteal nerve is damaged?
The gluteus minimus and medius are paralysed, and the pelvis becomes unsteady, giving Trendelenbergs sign
When is the Trendelenberg sign produced?
When the patient is asked to stand unassisted on each leg in turn
What will happen in a positive Trendelenberg sign?
Pelvic drop will occur on the unsupported leg
How is pelvic drop recognised?
By looking for the level of the iliac crests on both sides
Where are the deep gluteal muscles located?
Underneath the gluteus minimus
What is the general action of the deep gluteal muscles?
To laterally rotate the limb
To stabilise the hip joint
How do the deep gluteal muscles stabilise the hip joint?
By ‘pulling’ the femoral head into the acetabulum of the pelvis
Which muscles are considered to be deep gluteal?
Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris
Where does the piriformis lie?
Most superior of the gluteal muscles
What is the proximal attachment of the piriformis?
Anterior surface of sacrum
Sarcotuberous ligament
What is the distal attachment of the piriformis?
Superior border of greater trochanter of the femur
What is the innervation of the piriformis?
Branches of the anterior rami of S1, S2
What is the arterial supply of the piriformis?
Superior gluteal artery
Inferior gluteal artery
Internal pudendal artery
What does the piriformis work with for its main action?
The obturator internus and the superior and inferior gemelli
What does the obturator internus form?
The lateral walls of the pelvic cavity
What is the proximal attachment of the obturator internus?
The pelvic surface of the obturator membrane and surrounding bones
What is the distal attachment of the obturator internus?
Medial surface of the greater trochanter (trochanteric fossa) of the femur
What is the innervation of the obturator internus?
Nerve to obturator internus (L5, S1)
What is the arterial supply to the obturator internus?
Obturator artery
What are the gemelli?
Two narrow and triangular muscles
What separates the superior and inferior gemelli?
The obturator internus tendon
What is the proximal attachment of the superior gemelli?
Ischial spine
What is the proximal attachment of the inferior gemelli?
Ischial tuberosity
What is the distal attachment of the superior and inferior gemelli?
Medial surface of the greater trochanter (trochanteric fossa) of femur
What is the innervation of the superior gemellus?
Nerve to obturator internus (L5, S1)
What is the innervation of the inferior gemellus?
Nerve to quadratus femoris (L5, S1)
What is the arterial supply of the superior and inferior gemelli?
Inferior gluteal artery
What is the main action of the piriformis, obturator internus and superior and inferior gemelli?
Laterally rotate extended thigh and abduct flexed thigh
Steady femoral head in acetabulum
Where is the quadratus femoris?
The most inferior of the deep gluteal muscles, located below the gemelli and obturator internus
What is the proximal attachment of the quadratus femoris?
Lateral border of the ischial tuberosity
What is the distal attachment of the quadratus femoris?
Quadrate tubercle on the intertrochanteric crest of femur and area inferior to it
What is the innervation of the quadratus femoris?
Nerve to the quadratus femoris (L5, S1)
What is the arterial supply of the quadratus femoris?
Inferior gluteal artery
What is the main action of the quadratus femoris?
Laterally rotates thigh
Steadies femoral head in the acetabulum
What is the anatomical landmark of the gluteal region?
The piriformis
What happens as the piriformis travels through the greater sciatic foramen?
It effectively divides the gluteal region into an inferior and superior part
What does the division of the piriformis determine?
The name of the nerves and vessels that supply that area
What can the piriformis be used to locate?
The sciatic nerve
Where does the sciatic nerve enter the gluteal region?
Directly inferior to the piriformis
